The Sushruta Samhita — trans. Bhishagratna

of the patient, if unchecked until almost all the fundamental principles or elements Dhdtus are attacked by its virus in the course of time. 14.

Chap, v.] NibANA STHANAM. 4t

The symptoms of a case of Kushtham confined only to the serous (Tvaka) fluid of the skin are the loss of the perception of touch, a scanty perspiration, itching and discoloration and roughness of the affected part. The symptoms which manifest themselves when the disease is confined to the blood are complete anaesthesia, horripilation, absence of perspiration, itching and excessive accumulation of pus in the affected parts. The symptoms of Kushtham affecting only the flesh are thickness of the patches, dryness of the mouth, roughness and hardness of the patches which become covered with pustular eruptions and vesicles, and an excruciating pricking pain in, and numbness of, the affected part. The symptoms of (Kushtham) invading the principle of fat only are a fetid smell and an excessive accumulation of pus in the affected part and a breaking of the skin, exposing deep gashing wounds which soon become infested with parasites. The body seems as if covered with a plaster. Symptoms of (Kushtham) affecting only the bones and the marrow are a sinking (lit: breaking) of the nose, a redness of the eyes, loss of voice and the germination of parasites in the incidental ulcers. Symptoms of the disease restricting itself only to the principle of semen are a crippled state of the hands and distortion of the limbs, loss of the power of locomotion, spreading of ulcers and all the other symptoms peculiar to the preceding types of the disease. 15 — 20.

A child, which is the offspring of the contaminated semen and ovum of its parents afflicted with Kushtham, should be likewise regarded as a Kushthi. 21.

Prognosis: — A case of Kushtham appearing in a person of prudence and discretion and confined only to the serum (Tvaka), flesh and blood of his organism should be regarded as curable. A palliative treatp. 6p. 42ment is the only remedy in cases where the disease is found to invade the principle of fat ; whereas a case where the poison is found to have penetrated into any of the remaining organic principles should be given up as incurable. 22,

[Chap. V.

ment is the only remedy in cases where the disease is found to invade the principle of fat ; whereas a case where the poison is found to have penetrated into any of the remaining organic principles should be given up as incurable. 22,

Wise men hold that, for killing a Brahmana, or a woman, or one of his own relations, for theft, as well as for doing acts of impiety, a man is sometimes cursed with this foul disease by way of divine retribution. The disease reattacks a man even in his next rebirth in the event of his dying with it. Uncured Kushtham (leprosy) is the most painful, and most troublesome of all diseases. 23 — 24.

A Kushthi (leper), getting rid of this foul malady by observing the proper regimen of diet and conduct and by practising expiatory penances and by resorting to proper medicinal measures, gets an elevated status after death. 25.

Kushtham (Leprosy) is a highly contagious disease ; the contagion being usually communicated through sexual intercourse with a leper (Kushthi), or by his touch or breath, or through partaking of the same bed, and eating and drinking out of the same vessel with him, or through using the wearing apparel, unguents and garlands of flowers previously used by a person afflicted with this dreadful disease. Kushtham (Leprosy), fever, pulmonaiy consumption, ophthalmia and other Aupasargika disease (incidental to the influences of malignant planets or due to the effects of impious deeds) are communicated from one person to another. 26.

Thus ends the fifih Chipter of the Nidanaslhanam in the Sushruta
Samhila which treats of the Nidanam of cutaneous affections (Kushtham).

CHAPTEE VI.

Now we shall discourse on the Nidanam of Prameha (diseases of the urinary tracts), i.

It may be prognosticated that an idle man, who indulges in day sleep, or follows sedentary pursuits or is in the habit of taking sweet liquids, or cold and fat-making or emollient food, will ere long fall an easy victim to this disease. 2.

Pathology : —The bodily principles of Vdyu, Pittam and Kaphah of such a person get mixed with improperly formed chyle of the organism. Thus deranged, they carry down through the urinary ducts the deranged fat, etc.* of the body and find lodgment at the mouth (neck) of the bladder, whence they are emitted through the urethra -t", causing diseases, known by the (generic) name of Prameha. 3

p. 3

Premonitory symptoms: -A burning sensation in the palms of the hands and of the soles of the feet, a heaviness of the body, coldness or sliminess of the skin and limbs, sweetness and whiteness of the urine, somnolence, lassitude, thirst, a bad-smelling breath, a shortness of breath, slimy mucous deposit on the tongue, palate, pharyx and teeth, clotted hair and an inordinate growth of the finger and toe nails are the indications which mark the advent of the disease. 4.

General Characteristics:— A copious flow

of cloudy or turbid urine characterises all the types of the disease, which, together with the abscesses and eruptions (Pidaka) which mark its sequel, should be

* The particle "cha" in the text denotes other virus or morbific matter. Dallana.

t Remain incarcerated therein according to others.

p. 44

regarded as involving the concerted action of the deranged Doshas (Vayu, Pittam and Kaphah). 5.

The Kaphaja Types : —Cases of Prameha, which are caused by an exuberance of the deranged Kapham, may be grouped under ten subheads such as, Udaka-meha, Ikshu-meha, Sura-meJia, Sikata-meha, S'anai-meha, Lavana-meha, Pishta-meha, Scindra-meha, S'ukra-meha and Phena-meha. The ten aforesaid types are curable, inasmuch as the medicines which tend to remedy the deranged Kapham (Dosha), the cause of the disease, prove also remedial to the other principles of the body (flesh, marrow, blood, semen etc.) deranged (Dushya) from the same causes. 6.

The Pittaja Types : — The types, which are brought about through an exuberance of the deranged Pittam, are named as Nila-meha, Haridrd-meha, Amlameha, KsJiara-meha, ManjisJitha-ineha^ and S'onita-meha, Palliation is all that can be effected in these types, inasmuch as the medicines which tend to correct the deranged Pittam, which has brought on the disease, fail to exert similar virtues on the organic principles (Dushyas) deranged by it. 7.

The Vataja Types :— The types of Prameha which are produced by an aggravated condition of the bodily Vayu are divided into four subgroups, such as Sarpi-ineha, Vasd-meha, Kshoudra-meha and Hasti-ineha. These should be regarded as most incurable inasmuch as no kind of medicine can restore the fleet-coursing, deep diving {ie. invading the bones and the marrow) Vayu, which at the same time also augments the Pittam, to its normal state and thus advances (unchecked) in its work of disintegration. 8.

The deranged Kaphah, in conjunction with the (morbid) Pittam, Vayu and fat, gives rise to all Kaphaja